The Psychology of Hearing Loss

If we really want to understand hearing loss, we have to understand both the physical side, which makes hearing progressively more difficult, and the psychological side, which includes the lesser-known emotional reactions to the loss of hearing. Jointly, the two sides of hearing loss can wreak havoc on a person’s quality of life, as the physical reality creates the loss and the psychological reality prevents people from dealing with it.

The numbers tell the tale. Although almost all cases of hearing loss are physically treatable, only about 20% of people who would benefit from hearing aids use them. And even among people who do seek help, it takes an average of 5 to 7 years before they arrange a hearing test.

How can we explain the immense discrepancy between the possibility for better hearing and the widespread resistance to obtain it? The first step is to acknowledge that hearing loss is in fact a “loss,” in the sense that something valuable has been taken away and is apparently lost forever. The second step is to figure out how individuals generally react to losing something valuable, which, by way of the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand extremely well.

Elizabeth Kübler-Ross’ 5 stages of grief

Kübler-Ross defined 5 stages of grief that everyone coping with loss appears to go through (in remarkably consistent ways), although not everyone does so in the same order or in the same timeframe.

Here are the stages:

Denial – the individual buffers the emotional shock by denying the loss and imagining a false, preferable reality.

Anger – the individual recognizes the loss but becomes angry that it has happened to them.

Bargaining – the individual reacts to the feeling of helplessness by trying to take back control through bargaining.

Depression – understanding the significance of the loss, the individual becomes saddened at the hopelessness of the situation.

Acceptance – in the final stage, the individual accepts the situation and demonstrates a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the regaining of control over emotions and actions.

People with hearing loss progress through the stages at different rates, with some never reaching the last stage of acceptance — hence the gap between the potential for better hearing and the low numbers of people who actually seek help, or that otherwise hold off several years before doing so.

Progressing through the stages of hearing loss

The first stage of grief is the hardest to escape for those with hearing loss. Considering that hearing loss advances gradually through the years, it can be very difficult to recognize. People also tend to compensate for hearing loss by cranking up the TV volume, for instance, or by forcing people to repeat themselves. Those with hearing loss can persist in the denial stage for years, saying things like “I can hear just fine” or “I hear what I want to.”

The next stage, the anger stage, can reveal itself as a form of projection. You might hear those with hearing loss declare that other people mumbles, as if the problem is with everyone else rather than with them. People persist in the anger stage until they recognize that the issue is in fact with them, and not with others, at which point they may progress on to the bargaining stage.

Bargaining is a form of intellectualization that can take different forms. For example, people with hearing loss might compare their condition to others by thinking, “My hearing has become much worse, but at least my health is good. I really shouldn’t complain, other people my age are coping with genuine problems.” You may also find those with hearing loss devaluing their problem by thinking, “So I can’t hear as well as I used to. It’s just part of aging, no big deal.”

After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may go into a stage of depression — under the false presumption that there is no hope for treatment. They may persist in the depression stage for a period of time until they realize that hearing loss can be treated, at which point they can enter the last stage: the acceptance stage.

The acceptance stage for hearing loss is shockingly elusive. If only 20% of those who can benefit from hearing aids actually wear them, that means 80% of those with hearing loss never get to the final stage of acceptance (or they’ve arived at the acceptance stage but for other reasons decide not to act). In the acceptance stage, people recognize their hearing loss but take action to restore it, to the best of their ability.

This is the one positive side to hearing loss: in contrast to other types of loss, hearing loss is partially recoverable, making the acceptance stage much easier to reach. Thanks to major breakthroughs in digital hearing aid technology, people can in fact strengthen their hearing enough to communicate and engage normally in daily activities — without the stress and frustration of impaired hearing — enabling them to reconnect to the people and activities that give their life the most value.

Which stage are you in?

In the case of hearing loss, following the crowd is going to get you into some trouble. While 80% of those with hearing loss are trapped somewhere along the first four stages of grief — struggling to hear, damaging relationships, and making excuses — the other 20% have accepted their hearing loss, taken action to amplify it, and rediscovered the joys of sound.